Provider Demographics
NPI:1255621058
Name:HOBBS RECOVERY HOUSE
Entity type:Organization
Organization Name:HOBBS RECOVERY HOUSE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:ERVIN
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:II
Authorized Official - Credentials:N/A
Authorized Official - Phone:575-393-6245
Mailing Address - Street 1:218 W LEA ST
Mailing Address - Street 2:
Mailing Address - City:HOBBS
Mailing Address - State:NM
Mailing Address - Zip Code:88240-5110
Mailing Address - Country:US
Mailing Address - Phone:575-393-6245
Mailing Address - Fax:575-393-0225
Practice Address - Street 1:218 W LEA ST
Practice Address - Street 2:
Practice Address - City:HOBBS
Practice Address - State:NM
Practice Address - Zip Code:88240-5110
Practice Address - Country:US
Practice Address - Phone:575-393-6245
Practice Address - Fax:575-393-0225
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INTERNATIONAL WORD OF FAITH MINISTRY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-04-13
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness